Antidisialosyl antibodies were found in two out of 13 patients with chronic idiopathic ataxic neuropathy (CIAN) and not in 32 patients with different sensory neuropathies of known cause. This finding confirms the association of antidisialosyl antibodies and CIAN regardless of the absence of the M band. These antibodies may have pathogenic relevance; however, larger series are needed to establish their clinical significance.
BackgroundThere has been an increase in the number of chronic conditions concomitantly present in HIV-infected individuals and correspondingly, in comedication. Beliefs play a crucial role in medicines adherence.PurposeTo investigate the relationship between beliefs (necessity and concerns) of HIV-infected patients about comedication and their adherence.Material and methodsWe conducted a cross-sectional study between May–July 2014, that included HIV-infected patients treated with antiretroviral treatment (ART) and ≥1 additional drugs for other chronic diseases.The variables analysed in the study were demographics (sex, age), mode of transmission, CD4+, HIV plasma viral load, beliefs about comedication and adherence to treatment for chronic conditions.The Beliefs about Medicines Questionnaires (BMQ) was used to assess patients’ beliefs about drugs for additional diseases. The BMQ-Specific has two scales (necessity and concern) with five questions each that uses a 5-point Likert scale (1 = strongly disagree, 2 = disagree, 3 = uncertain, 4 = agree, 5 = strongly agree). A total score per scale was calculated. Self-reported comedication adherence was measured using the 4-item Morisky Medication Adherence Scale (MMAS). MMAS scores were dichotomised into adherent/non-adherent.Internal consistency within BMQ scales was measured with Cronbach’s α and their association with adherence was assessed with t-Student tests, using SPSS 20.0.ResultsWe included 126 patients (80.4% male, mean age 50.4 ± 8.3). Injected drug use was the main mode of transmission. 43.7% of patients presented CD4+ ≤ 500 cells/mm3 and 25.4%, detectable viral load. The mean number of additional medicines was 2.9 ± 2.0.The percentage of non-adherent patients was 54.0%. Belief in necessity was positively related to self-reported adherence. No relationship between adherence and concern was found. Internal consistency for BMQ-Specific was high (Cronbach’s alfa = 0.724) which indicates high intercorrelation between items.Abstract CP-025 Table 1BMQ-Specific scale> Cronbach´s alfa Non-Adherent (Mean±SD)Adherent (Mean±SD) p-value Necessity0.79417.3 ± 5.618.8 ± 4.40.188Concern 0.785 14.6 ± 5.7 12.1 ± 6.1 0.019ConclusionGreater conviction that comedication is necessary was associated with higher self-reported adherence in HIV infected-patients, suggesting that it could be important to focus on the necessity of this treatment to improve adherence.References And/or AcknowledgementsPlos One 2013;8(12):e80633No conflict of interest.
BackgroundMedication regimen complexity index (MRCI) has been identified as a predictor of sustained virologic response in patients treated with peginterferon and ribavirin for chronic hepatitis C.PurposeTo determine the influence of the MRCI in the premature discontinuation of triple therapy treatment with boceprevir or telaprevir in hepatitis C virus-HIV (HCV/HIV) coinfected patients.Material and methodsWe conducted a multicentre and prospective study that included HCV/HIV coinfected patients treated with triple therapy with boceprevir or telaprevir in combination with peginterferon-alpha plus ribavirin between January and December 2013. Basal variables colleted were: age, gender, hepatits C treatment-naïve or previously treated, presence of cirrhosis, psiquiatric disorder. We evaluated the proportion of patients achieve extended rapid virologic response (RVRe), defined as HCV RNA negative between 4 and 12 weeks of treatment with telaprevir and between 8 and 24 weeks of treatment with boceprevir. The rate of premature therapy discontinuation with the PI and reasons were collected. To calculate the MRCI, we considered all prescribed drugs and used the tool developed by McDonald et al.1 To determine the independent predictors of therapy discontinuation, we performed a multivariate logistic regression analysis.Results55 patients of three different centres were included (86.4% were men and the mean age was 48 years (SD = 3.7)). 68.0% were non-naive. 90.7% had cirrhosis. 83.1% achieved RVRe. 18 patients (30.5%) prematurely discontinued the treatment. Reasons for treatment discontinuation included adverse events (50.0%), lack of efficacy (33.0%) and refusal to continue the medication (17.0%). The mean MRCI was significantly higher in patients who discontinued the therapy (31.11 vs. 26.16). In the multivariate analysis, the only predictor of premature discontinuation of the therapy was the MRCI (OR = 1.17, p = 0,009; 95% CI (1.04–1.53).ConclusionThe MRCI is an independent predictor of premature discontinuation of the triple therapy with boceprevir and telaprevir in HCV/HIV coinfected patients.References and/or Acknowledgements1 McDonald MV, Peng TR, Sridharan S, et al. Automating the medication regimen complexity index. J Am Med Inform Assoc 2013;20(3):499–505No conflict of interest.
BackgroundSince the introduction of HAART, HIV has become a chronic disease. Maintaining adherence and persistence to treatment are key elements in the pharmacotherapeutic follow-up. Persistence adds the dimension of time to the analysis and represents the time over which a patient continues to collect a prescription.PurposeTo determine the persistence with treatment-naive HIV+ patients in the PSITAR cohort.Material and methodsProspective multicentre study. Inclusion criteria: treatment-naïve patients who started antiretroviral therapy in 2011 and 2012 and monitoring in pharmaceutical care consultations of the centres involved. Demographic characteristics, virological parameters and pharmacotherapy variables: regimen prescribed, adherence to treatment, time to discontinuation and its cause.Patients were classified according to the treatment received: 2NRTI + NNRTI, 2 NRTI + PI/r or 2NRTI + INSTI.HAART persistence was measured as the time (in weeks) from the start of treatment until discontinuation due to treatment modification or abandonment for more than 90 days.The evolution of persistence was tracked through survival curves using the Kaplan-Meier method, even considering no persistence.Results227 patients were included, 82.4% men. The mean age was 40 ± 11. The most frequent HAART consisted of 2NRTI + NNRTI (65.6%). A percentage of 43.2% was persisting with the same initial treatment at the end of the observation period. The median time to discontinuation was 76.4 weeks (CI95%: 56.8–96.0) and the main cause of discontinuation was adverse effects (70.6%).Median persistence was 88.8 (CI95%: 73.2–104) weeks for the treatment with 2NRTI + NNRTI, 42.4 (CI95%: 35.2–50.0) with 2 NRTI + PI/r and 29.6 (CI95%: 4.8–54.4) with 2NRTI + INSTI.Statistically significant differences were found in time to discontinuation between treatment groups with a third drug NNRTI versus PI/r (p = 0.001), the higher time to discontinuation being in the NNRTI group.ConclusionPatients starting antiretroviral therapy with 2NRTI + NNRTI had better persistence with a median time to discontinuation of nearly two years.ReferencesNDT 2014;10:1543–69Value Health 2008;11(1):44–7No conflict of interest.
BackgroundHighly active antiretroviral therapy (HAART) has significantly reduced morbidity and mortality, transforming HIV into a chronic disease. The increase in life expectancy in these patients has led to a higher prevalence of comorbidities and use of concomitant medicines, which may limit adherence and therapeutic success.PurposeTo determine the prevalence of other chronic diseases in HIV-infected patients and to identify predictors of non-adherence to HAART.Material and methodsSingle-centre retrospective study that included HIV-infected patients on HAART who attended pharmaceutical care at a pharmacy service from January to December 2013. The dependent variable was non-adherence to HAART (patients were considered non-adherent to HAART if the percentage of adherence through dispensing records was ≤90%). The independent variables were: sex, age, number of chronic diseases and concomitant medicines, and the presence of specific diseases (viral liver disease, dyslipidaemia, central nervous system disease, cardiovascular disease or hypertension).Statistical analysis: to identify independent predictors of non-adherence, we performed a multivariate logistic regression analysis.ResultsA total of 598 patients were analysed. 78.9% were men, mean age was 48 years (IQR: 42–52). The average number of comorbidities per patient was 1.6 ± 1.4. 31.3% of patients had viral liver disease, 17.9% dyslipidaemia, 15.6% central nervous system disease and 14.4% cardiovascular disease or hypertension. The average number of concurrent drugs per patient was 1.9 ± 2.7. 85.3% of patients were adherent to HAART. In the multivariate analysis, presence of viral liver disease was the only variable significantly associated with non-adherence to HAART (OR: 1.81); p = 0.02). The number of chronic diseases and concurrent drugs was not associated with non-adherence.ConclusionThe prevalence of other chronic diseases in HIV-infected patients was high. The presence of viral liver disease was identified as a predictor of non-adherence in HIV-patients in this study.ReferenceGleason LJ, et al. Polypharmacy in the HIV-infected older adult population. Clin Interv Aging 2013;8:749–63No conflict of interest.
Background The life expectancy of HIV-infected individuals has increased, and there are many patients with other comorbidities and comedication, which could affect antiretroviral therapy (ART) adherence. Purpose To investigate the effect of polypharmacy on ART adherence in patients with HIV infection, as well as to identify predictors of ART adherence. Materials and methods A single-centre, retrospective study was conducted on HIV-infected patients who had started treatment before January 2012. The follow-up period was 12 months. The dependent variable was ART adherence and the independent variables were; sex, age, CD4, transmission risk, CDC classification, ART-naive, HIV viral load, number of hospital admissions, type of ART, comedication (≥5 prescription drugs) and risk of drug-related problems (DRP). Adherence was determined through pharmacy electronic dispensing records and the Morisky scale. Patients were considered adherent when they took ≥90% of prescribed ART in the last 12 months. The risk of DRP (categorised as high or low) was determined by a predictive tool developed by Morillo et al.1 To determine the independent variables associated with adherence, we performed a univariate logistic regression and subsequently a multivariate analysis. Results We included 594 patients in the study (80% men, median age 47 years) of whom 75% were adherent. In the univariate analysis the variables that showed statistically significant relationships with ART adherence were: intravenous drug users (IDU), AIDS-defining condition, ART-naïve, detectable viral load, ≥1 hospital admission, PI-based regimens, high-risk DRP and polypharmacy. In the multivariate analysis, IDU (OR = 0.58; CI[0.34–0.99]; p = 0.048); ART-naïve (OR = 9.94; CI[3.69–26.79]; p < 0.001); high-risk DRP (OR = 0.41; CI[0.24–0.69]; p = 0.001) and polypharmacy (OR = 0.39; CI[0.22–0.68]; p = 0.001) were independent predictors of non-adherence to ART. Conclusions Although ART adherence is high, polypharmacy significantly reduces adherence. Similar findings have been reported by other studies.2,3 This fact justifies the key role that the pharmacist can play in adherence monitoring. Furthermore, non-treatment-naive patients, IDU and high-risk DRP are also associated with lower adherence. References (28) Ekwunife OI, Oreh C, Ubaka CM. Concurrent use of complementary and alternative medicine with antiretroviral therapy reduces adherence to HIV medications. Int J Pharm Pract 2012;20(5):340-3 Nachega JB, Trotta MP, Nelson M, Ammassari A. Impact of metabolic complications on antiretroviral treatment adherence: clinical and public health implications. Curr HIV/AIDS Rep 2009;6(3):121-9 No conflict of interest.
BackgroundComorbid chronic conditions have increased among HIV-infected patients. Little work has studied adherence rates for long-term medicines (LTMs).PurposeTo assess adherence to other LTMs (non-antiretroviral therapy) among HIV-infected patients as well as to evaluate its relationship with clinical and therapeutic factors.Material and methodsA cross-sectional study was conducted from May to July 2014 in HIV-infected patients treated with ART and ≥1 LTM. The following variables were collected: sex, age, living situation, employment status, mode of transmission, T-CD4, viral load, CDC classification, type of ART and adherence to other LTM (non-antiretroviral treatment), using the 4-item Morisky Medication Adherence Scale. The chi-squared test was applied to examine the role of the different variables on adherence, using SPSS 20.0.Results126 patients were included (80.4% male, mean age 50.4 ± 8.3). Injection drug use was the main mode of transmission (61.9%). The median T-CD4 was 538.5 cells/mm3 (IQR: 341.1–778.2). Most of patients presented T-CD4 ≥ 500 cells/mm3 (56.3%) and undetectable viral load (74.6%). 63.5% of them had AIDS. ART was mainly (36.5%) two nucleoside/nucleotide reverse transcriptase inhibitors (NRTIs) with one non-nucleoside reverse transcriptase inhibitor (NNRTI). The percentage of patients adherent to other LTMs (non-antiretroviral therapy) was 46.0%. The variable AIDS exhibited a statistically significant relationship with non-adherence (OR = 2.2; CI [1.1–4.7]; p = 0.041). The most common long-term medicines were sedatives and anxiolytics (42.9%), lipid-lowering drugs (35.7%), antihypertensives (33.3%), gastrointestinals (28.6%), antidepressants (15.1%), antidiabetics (12.7%), analgesics (11.1%), antiasthmatics (9.5%) and cardiovascular drugs (87.9%).Abstract CP-010 Table 1Variable: n (%)Non-Adherent (n = 68)Adherent (n = 58)p-ValueAge ≥ 50 years30 (44.1)26 (44.8)1.000Gender: female14 (20.6)12 (20.7)1.000Living alone18 (26.5)11 (19.0)0.399Employment status: employed16 (23.5)19 (32.8)0.399Mode of transmissionSexualInjection drug use21 (30.9)47 (69.1)27 (46.6)31 (63.4)0.097Detectable viral load (>20 copias/ml)18 (26.5)14 (24.1)0.839T-CD4 ≥ 500 Cells/mm3 38 (55.9)33 (56.9)1.000AIDS49 (72.1)31 (53.4)0.041Type of ART2NRTIs + NNRTI2NRTIs + IP/rOthers25 (36.8)20 (29.4)23 (33.8)21 (36.2)21 (36.2)16 (27.6)0.657ConclusionPatients showed a low level of adherence to other LTMs. This study allowed us to attempt to educate HIV-infected patients with suboptimal adherence.References and/or acknowledgementsCantudo-Cuenca MR, Jiménez-Galán R, Almeida-Gonzalez CV, et al. Concurrent use of comedications reduces adherence to antiretroviral therapy among HIV-infected patients. J Manag Care Pharm 2014;20(8):844–50No conflict of interest.
BackgroundTreatment of immune thrombocytopenic purpura (ITP) is a controversial subject. The management varies widely, ranging from observation only, to aggressive management with corticosteroids, intravenous anti-RhD, intravenous immunoglobulin (IVIG), rituximab, splenectomy, etc.PurposeTo assess the effectiveness of treatment by administration of immunoglobulins (Ig) in patients diagnosed with idiopathic thrombocytopenic purpura (ITP).Material and methodsRetrospective descriptive study of about 5 years (January 2009–March 2014). All administrations of Ig in patients diagnosed with ITP in our study period.The variables analysed were: sex, age, dose Ig, number of administrations to each patient, pre-treatment with corticosteroids, effectiveness of treatment with Ig (being defined as platelet levels increasing to above 30–109/l, as indicated by the clinical guidelines for the use of Ig).Patients and clinical data were selected from the outpatient and inpatient records (Farmatools) and electronic patient clinical histories.ResultsA total of 23 patients were treated with PIT Ig in the study period. 6 patients were excluded because their clinical data had not been collected. 17 patients (two of whom were paediatric patients) of whom 41% were males were included. The mean age was 48 years.The mean dose administered per patient was 40.44 grams of Ig. Mean Ig administration per patient in the study period was two administrations per patient.Pre-treatment with corticosteroids as first-line treatment was performed in 88.23% of patients.Of the 34 administrations recorded, 61.76% were found to be effective according to the clinical guidelines for the use of Ig for the treatment of ITP.ConclusionIg treatment had a higher than 60% efficacy, so it is justified to use it in symptomatic treatment prior to corticosteroids in patients diagnosed with ITP.ReferenceIndian Pediatr 2013;50(6):611No conflict of interest.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.